Changes in coronal knee-alignment parameters during the osteoarthritis process in the varus knee.

Objectives: The idea to aim for an "individualized" alignment, whereby the constitutional alignment is restored, has gained much interest among knee surgeons. This requires insight into the prediseased, natural alignment of our patients' knees. The aim of this study is (1) to determine how the hip-knee-ankle (HKA) angle is influenced during the arthritic process and (2) to investigate the correlation between joint line changes and the progression of osteoarthritis (OA).

The biomechanical fingerprint of hip and knee osteoarthritis patients during activities of daily living.

Background: Osteoarthritis is a highly prevalent disease affecting the hip and knee joint and is characterized by load-mediated pain and decreased quality of life. Dependent on involved joint, patients present antalgic movement compensations, aiming to decrease loading on the involved joint. However, the associated alterations in mechanical loading of the ipsi- and contra-lateral lower limb joints, are less documented.

The pre-diseased coronal alignment can be predicted from conventional radiographs taken of the varus arthritic knee.

Introduction: The concept of restoring the constitutional, pre-diseased alignment has gained lots of interest among knee surgeons. Previous attempts to use the contralateral limb to bridge the gap between the arthritic and the constitutional alignment were unsuccessful. We investigated the usability of a mathematical formula to predict the constitutional (pre-diseased) coronal alignment once arthritis has occurred.

Combined lateral extra-articular tenodesis and anterior cruciate ligament reconstruction: risk of osteoarthritis.

Purpose: Lateral extra-articular tenodesis (LET) procedure, combined with an intra-articular reconstruction of the anterior cruciate ligament (ACL), is used to reduce rotational laxity and the risk of graft failure. However, concern of overtightening of the lateral compartment and subsequent osteoarthritis remains. The aim of this study is to evaluate the degenerative changes in the lateral compartment and to compare the clinical and radiographical results between two LET techniques.

The initial learning curve for the ROSA® Knee System can be achieved in 6-11 cases for operative time and has similar 90-day complication rates with improved implant alignment compared to manual instrumentation in total knee arthroplasty.

Purpose: The purpose of this study was to determine the learning curve for total operative time using a novel cutting guide positioning robotic assistant for total knee arthroplasty (raTKA). Additionally, we compared complications and final limb alignment between raTKA and manual TKA (mTKA), as well as accuracy to plan for raTKA cases.

Methods: We performed a retrospective cohort study on a series of patients (n = 180) that underwent raTKA (n = 90) using the ROSA Total Knee System or mTKA (n = 90) by one of three high-volume (> 200 cases per year) orthopaedic surgeons between December 2019 and September 2020, with minimum three-month follow-up.

Rehabilitation strategies of Flemish physical therapists before and after anterior cruciate ligament reconstruction: An online survey.

Objectives: The primary objective of the study was to investigate rehabilitation strategies of Flemish physical therapists before and after anterior cruciate ligament (ACL) reconstruction. Secondly, we aimed to investigate physical therapists' preferences on continuing education and evaluate their self-rated confidence and competence when treating patients before and after ACL reconstruction.

Design: Survey-based study.

A revisited technique for combined anterior cruciate ligament and anterolateral ligament reconstructions.

A new technique for combined anterior cruciate ligament and anterolateral ligament reconstructions is described. An iliotibial band strip is used as an ALL graft , leaving the distal insertion intact and fix it with a knotless anchor on the femoral origin, after tunneling it under the lateral collateral ligament.

Functional movement assessment by means of inertial sensor technology to discriminate between movement behaviour of healthy controls and persons with knee osteoarthritis.

Background: Apart from biomechanical alterations in movement patterns, it is known that movement limitations in persons with knee osteoarthritis (PwKOA) are related to an individual's perception and belief regarding pain and disability. To gain more insights into the functional movement behaviour of PwKOA in a clinical setting, inertial sensor technology can be applied. This study first aims to evaluate the ability of inertial sensors to discriminate between healthy controls (HC) and PwKOA.

The Role of the Posterolateral Tibial Slope in the Rotational Instability of the Knee in Patients Affected by a Complete Isolated Anterior Cruciate Ligament Injury: Its Value in the Decision-Making Process during the Anterolateral Ligament Reconstruction.

 The aim of this retrospective, multicenter study was to investigate the correlation between a high degree of rotatory instability, posterolateral tibial slope (PLTS), and anterolateral ligament (ALL) injury.  The study population consisted of 76 adults with isolated, complete noncontact anterior cruciate ligament (ACL) tear. The sample was divided into two groups according to the preoperative degree of rotator instability (group A: pivot-shift test grades 2 and 3; group B: pivot-shift test grade 1).

Discriminant validity of 3D joint kinematics and centre of mass displacement measured by inertial sensor technology during the unipodal stance task.

Background: The unipodal stance task is a clinical task that quantifies postural stability and alignment of the lower limb joints, while weight bearing on one leg. As persons with knee osteoarthritis (KOA) have poor postural and knee joint stability, objective assessment of this task might be useful.

Objective: To investigate the discriminant validity of three-dimensional joint kinematics and centre of mass displacement (COM) between healthy controls and persons with knee KOA, during unipodal stance using inertial sensors.

Test-retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests.

Background: Single-leg hop tests are commonly performed in the forward direction to evaluate functional performance. However, athletes move in multiple directions during pivoting sports. The first aim of this study was to examine test-retest reliability of single-leg hop tests in the forward, medial and rotational direction in non-injured athletes.

Risk analysis of tunnel collision in combined anterior cruciate ligament and anterolateral ligament reconstructions.

Background: To assess the risk of tunnel collision in combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstructions.

Methods: Three-dimensional (3D) CT reconstructions of 32 knees after transtibial (TT) (N = 16) or anteromedial portal (AMP) (N = 16) ACL reconstruction were used to simulate potential tunnel collision of the femoral ACL tunnel if combined with a virtual ALL reconstruction. The minimal distance between tunnels, the ALL tunnel length, and the lateral femoral condyle (LFC) width were measured.

Hinged versus CCK revision arthroplasty for the stiff total knee.

Background: Total knee arthroplasty (TKA) remains the gold standard for end-stage knee osteoarthritis. The prevalence of stiffness after this procedure described in literature varies from 1.3% to 5.

High risk of tunnel convergence during combined anterior cruciate ligament and anterolateral ligament reconstruction.

Purpose: To assess the risk of femoral tunnel convergence in combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstructions. The hypothesis was that a more proximal and anterior orientation of the ALL femoral tunnel should reduce the risk of convergence with the ACL femoral tunnel.

Methods: 15 fresh-frozen cadaver knees were examined.

The effect of haemodynamic and peripheral vascular variability on cardiac output monitoring: thermodilution and non-invasive pulse contour cardiac output during cardiothoracic surgery.

While haemodynamic variability interferes with the assumption of constant flow underlying thermodilution cardiac output calculation, variability in (peripheral) arterial vascular physiology may affect pulse contour cardiac output methods. We compared non-invasive finger arterial pressure-derived continuous cardiac output measurements (Nexfin ) with cardiac output measured using thermodilution during cardiothoracic surgery and determined the impact of cardiovascular variability on either method. We compared cardiac output derived from non-invasive finger arterial pressure with cardiac output measured by thermodilution at four grades (A-D) of cardiovascular variability.

Cerebral autoregulatory performance and the cerebrovascular response to head-of-bed positioning in acute ischaemic stroke.

Background And Purpose: Cerebrovascular responses to head-of-bed positioning in patients with acute ischaemic stroke are heterogeneous, questioning the applicability of general recommendations on head positioning. Cerebral autoregulation is impaired to various extents after acute stroke, although it is unknown whether this affects cerebral perfusion during posture change. We aimed to elucidate whether the cerebrovascular response to head position manipulation depends on autoregulatory performance in patients with ischaemic stroke.

Effect of anticipation and cuff inflation on blood pressure during self-measurement.

Background: Self-measurement of blood pressure (BP) is increasingly being used for the diagnosis of hypertension and to monitor BP at home. Whenever compared with ambulatory BP measurements, home BP values are frequently higher and less predictive for incident cardiovascular events. We hypothesized that this could be caused by a pressor response elicited by the self-measurement of BP.

Blood pressure reduction after gastric bypass surgery is explained by a decrease in cardiac output.

Unlabelled: Blood pressure (BP) decreases in the first weeks after Roux-and-Y gastric bypass surgery. Yet the pathophysiology of the BP-lowering effects observed after gastric bypass surgery is incompletely understood. We evaluated BP, systemic hemodynamics, and baroreflex sensitivity in 15 obese women[mean age 42 ± 7 standard deviation (SD) yr, body mass index 45 ± 6 kg/m] 2 wk before and 6 wk following Roux-and-Y gastric bypass surgery.

Cerebral tissue oxygen saturation values in volunteers and patients in the lateral decubitus and beach chair positions: a prospective observational study.

Background: The objective of this study was to describe changes in cerebral tissue oxygen saturation (SctO2) due to changes in body position in healthy volunteers and in patients undergoing surgery under general anesthesia in the beach chair position (BCP) and lateral decubitus position (LDP).

Methods: In this prospective observational study, SctO2 was measured in 85 awake volunteers serially positioned every 15 min, beginning with the supine position (SP) and followed by the beach chair, supine, and lateral decubitus positions. Cerebral tissue oxygen saturation was also measured supine and in either the BCP or the LDP in 195 patients (according to surgical preference) undergoing elective arthroscopic shoulder surgery.

High-energy bilateral knee dislocations in a young man: a case report.

Bilateral knee dislocations are rare. We report one such case in a 22-year-old man. His clinical presentation, radiographical findings, and the operative and non-operative treatments are discussed, with emphasis on the timing of treatment and rehabilitation.

Noninvasive continuous hemodynamic monitoring.

Monitoring of continuous blood pressure and cardiac output is important to prevent hypoperfusion and to guide fluid administration, but only few patients receive such monitoring due to the invasive nature of most of the methods presently available. Noninvasive blood pressure can be determined continuously using finger cuff technology and cardiac output is easily obtained using a pulse contour method. In this way completely noninvasive continuous blood pressure and cardiac output are available for clinical use in all patients that would otherwise not be monitored.

Noninvasive continuous arterial blood pressure monitoring with Nexfin®.

Background: If invasive measurement of arterial blood pressure is not warranted, finger cuff technology can provide continuous and noninvasive monitoring. Finger and radial artery pressures differ; Nexfin® (BMEYE, Amsterdam, The Netherlands) measures finger arterial pressure and uses physiologic reconstruction methodologies to obtain values comparable to invasive pressures.

Methods: Intra-arterial pressure (IAP) and noninvasive Nexfin arterial pressure (NAP) were measured in cardiothoracic surgery patients, because invasive pressures are available.

Orthostatic leg blood volume changes assessed by near-infrared spectroscopy.

Standing up shifts blood to dependent parts of the body, and blood vessels in the leg become filled. The orthostatic blood volume accumulation in the small vessels is relatively unknown, although these may contribute significantly. We hypothesized that in healthy humans exposed to the upright posture, volume accumulation in small blood vessels contributes significantly to the total fluid volume accumulated in the legs.